1/6. Traumatic asphyxia complicated by unwitnessed cardiac arrest.We report a case of traumatic asphyxia complicated by unwitnessed cardiac arrest in which the patient has made a good, functional recovery. Traumatic asphyxia is an uncommon clinical syndrome usually occurring after chest compression. Associated physical findings include subconjunctival hemorrhage and purple-blue neck and face discoloration. These facial changes can mimic those seen with massive closed head injury; however, cerebral injury after traumatic asphyxia usually occurs due to cerebral hypoxia. When such features are observed, the diagnosis of traumatic asphyxia should be considered. Prompt treatment with attention to the reestablishment of oxygenation and perfusion may result in good outcomes.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Conjunctival lymphoid hyperplasia presenting with bilateral panuveitis.PURPOSE: To report on a case of bilateral conjunctival lymphoid hyperplasia presenting with bilateral panuveitis in a female patient. DESIGN: Observational case report. methods: In this case excisional biopsy indicated lymphoid tissue. immunohistochemistry showed a follicular architecture with appropriate zoning of B and T lymphocytes. RESULTS: Causes of panuveitis were considered and excluded based on a detailed history, physical examination, and laboratory investigations. The bilateral panuveitis resolved on topical corticosteroids and visual acuity returned to normal. CONCLUSIONS: Ocular adnexal lymphoproliferative lesions consist of a spectrum of disease entities, including reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma. There are no established clinical criteria to differentiate between these lesions. This case highlights the importance of a thorough ophthalmic examination in these patients, as an intra-ocular inflammatory process may accompany the conjunctival findings. Furthermore, we advocate periodic follow-up examinations because of the small potential risk of developing ocular or systemic lymphoma in these patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/6. Pseudohypopyon in acute myelogeneous leukemia.An 11-month-old boy presented with uniocular hypopyon, elevated intraocular pressure, and iris nodules. A differential diagnosis of physical abuse, infection, retinoblastoma, juvenile xanthogranuloma, and histiocytosis X were considered but initial physical and laboratory investigations all had normal results. Three weeks following initial presentation, the child developed fulminant acute myelogenous leukemia. The clinical course, investigations, and outcome are reviewed.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
4/6. Ocular cicatricial pemphigoid. A case report of monozygotic twins discordant for the disease.OBJECTIVE: To identify the major histocompatibility complex markers and the autoantibody associated with ocular cicatricial pemphigoid (OCP) in a proband, her unaffected cotwin, and the children of the cotwin. Ocular cicatricial pemphigoid is a chronic autoimmune disorder that affects the conjunctiva and other squamous epithelium. It is associated with the major histocompatibility complex class II alleles that are presumed to provide enhanced susceptibility to the disease. We encountered a pair of monozygotic female twins, one of whom has OCP. In addition to totally identical physical appearances since birth, the two sisters have identical blood groups. methods: The following studies were performed on the patient, her unaffected cotwin sister, and her children: (1) polymorphism of major histocompatibility complex class II genes by dna typing, (2) sequence analysis of DQ beta gene second and third exons, and (3) serologic evaluation for the presence of anti-basement membrane zone autoantibodies specific for OCP by Western immunoblot with the use of skin and conjunctiva lysates as substrates. RESULT: Both monozygotic twins had the same HLA haplotypes. The sequence analysis of the second and third exons of DQ beta genes revealed no significant differences between the proband and her unaffected cotwin. autoantibodies specific to OCP were detected only in the patient's serum. The serum of the unaffected cotwin and the other relatives did not demonstrate the presence of the OCP autoantibody. CONCLUSION: This isolated family study does not support a single-gene theory for the development of OCP. It is most likely due to a multigene effect and associated with environmental factors.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/6. amyloid plaque of the lower eyelid: a patient report and review of the literature.Localized conjunctival amyloid plaque is a rare disorder. It usually remains localized and is only rarely associated with systemic disease, unlike cutaneous amyloid deposits of the eyelid. The pathogenesis is unknown, but appears to be related to long-standing chronic inflammation. There may be a localized immunological disorder or an underlying systemic disease in rare instances. Because of this possible association, all patients should undergo through physical examination with close follow-up to rule out systemic disease. Plastic surgeons need to be aware of this lesion because the diagnosis is easily missed, clinically. The primary clinical working diagnosis before biopsy is a neoplasm, and recognition of this entity can prevent unnecessarily radical surgery.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/6. Septic thrombosis of orbital vessels due to cutaneous nasal infection.The authors describe two cases of cutaneous nose infection that quickly spread and extended to the orbital venous complex. At first glance, the clinical presentation could be mistaken for a complicated sinusal infection; therefore, the evaluation of the sinuses, by means of physical examination and radiological investigation, was of great concern, showing that there was no important pathology in the sinuses. The CT scan and the color Doppler imaging (orbital ultrasound with Doppler) demonstrated, throughout the development of the disease, that the superior ophthalmic vein was affected in both patients and the cavernous sinus in one of them. On physical examination, chemosis of the conjunctiva, proptosis, and edema of the eyelids were prominent. patients improved only after appropriate intravenous antibiotic therapy against staphylococcus (clindamycin) and corticosteroids, making one conclude that treatment of this disease should be initiated as soon as possible in order to decrease morbidity and mortality.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |